Role: HealthRules Configuration Lead
Location: Sacramento, CA (4 Days Onsite)
Duration: Long Term
Job Description:
Primary Responsibilities
- Lead HealthRules configuration activities for commercial group products, including:
- Benefits configuration
- Pricing and accumulator logic
- Provider contracts
- Claims processing rules
- Triage, prioritize, and manage the configuration backlog, including:
- Production defects
- Enhancement requests
- Annual readiness and renewal activities
- Act as the primary intake point for configuration work from business owners and operations teams
- Coordinate configuration handoffs and testing support with the offshore QA team
- Provide technical guidance, oversight, and configuration code review for configuration analysts
- Ensure configuration aligns with approved business requirements and testing standards
- Deliver weekly status reporting to Client
- Support operational stability
- Operate in a ~20% supervisory / lead capacity, with the remainder in hands‑on configuration and analysis
Required Skills & Experience
- 7+ years of hands‑on HealthRules Payer configuration experience
- 3+ years supporting commercial group health plan configuration, including:
- Deductibles
- Out‑of‑pocket maximums
- Accumulators
- Tiered benefit designs
- Expert‑level proficiency with:
- HealthRules Designer
- HealthRules Manager
- HealthRules Language (HRL)
- Demonstrated experience acting as a configuration lead or technical lead on HealthRules projects
- Strong understanding of end‑to‑end claims processing and benefits configuration
- Strong communication skills with ability to:
- Partner with business stakeholders
- Explain technical configuration decisions clearly
Preferred Qualifications
- Experience with provider network configuration and pricing schedules
- Prior experience working in a staff augmentation or managed services delivery model
- Experience supporting annual benefit renewals and readiness cycles
- Experience working with offshore QA or testing teams
Education
- Bachelors of Engineering or related fields.
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